Erciyes T1p Dergisi 14:31-38, 1992

YENtDOGAN DONEMI SARILIKLARINDA ERlTROStT ZARI Na+-K+ATPaz, Mg2+ATPaz VE MAGNEZYUM llt$KtLERI

*Sefer Kumandal}** Hatice Pa§ao~jlu ***Sabahattln Muhtaro{llu* Kaz1m Ozom **** ZObeyde GOndOz * Mustafa Kendircl ·

Ozet: Yenidogan doneminde gorOien indirekt hiperbilirubineminin eritrosit zan Na+-

K+ATPaz, Mg2+ATPaz aktivitelerine etkisi ile plazma magnezyum dOzeyleriyle ili~kisinin incelenmesi amac;lanan bu c;al1~mada 1 O'u hemolitik, 14'0 nonhemolitik, 13'0 kontrol toplam 37 yenidogan bebek c;al1~ma kapsam~na allnd1.

Hastalarm hemoglobin, periferik yayma, retikOiosit, coombs, bilirubin, intrauterin infeksiyonlar yonOnden serolojik testleri, eritrosit zan Na+-K+ATPaz, Mg2+ATPaz aktiviteleri, plazma magnezyum dOzeyleri olc;OidO. Hemolitik ve nonhemolitik grupta

Na+-K+ATPaz, Mg2+ATPaz aktiviteleri ve

plazma Mg2+ dOzeyleri kontrol grubundan anlamll olarak dO~Ok bulundu.

Anahtar Kellmeler: Na+-K+ATPaz, Mg2+ ATPaz, Plazma magnezyum.

Red blood cell membrane Na+-K+ATPase,

Mg2+ATPase and magnesium corelat1on in newborn period jaundice

Summary: The evaluation of neonatal indirect hyperbilirubinemia on red blood cell membrane Na+-K+ATPase and

Mg2+ ATPase activity, and the correlation of these parameters with plasma magnesium levels was the aim of this study. Totally 37 newborn babies- 10 haemolytic,14 nonhaemolytic and 13 from control group-were included in this study.

Haemoglobin, peripheric blood smear. reticulocyte, coombs, bilirubin, serologic tests regarding intrauterine infections, red blood cell membrane Na+-K+ATPase and Mg2+ ATPase activity, plasma magnesium

levels of the patients were measured. Na+-K+ATPase and Mg2+ATPase activities and

plasma Mg2+ levels were found to be significantly lower in haemolytic and nonhaemolytic groups than in the control group. Key words:Na+-K+ATPase, Mg2+ATPase, Plasma magnesium

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Yenidogan Donemi San!Jklannda Eritrosit Zan Na+ -K+ A TPaz, Mg2+A TPaz ve Magnezyum fli$-kileri: KUMANDA$ Sefer ve ark.

Yenidogan doneminin onemli problemlerinden biri olan sanllk, plazmadaki bilirubinin karacigerin metabolize etme gucono a§tiQI durumlarda gorulen klinik tablodur. Vakalann bir k1smmdan hemolize yol a

Yenido(Jan Donemi San!Jklannda Eritrosit Zan Na+ -J

Yenidogan Donemi Sanl1klannda Eritrosit Zan Na+ -K+ ATPaz, Mg2+ATPaz ve Magnezyum lli$-kileri: KUMANDA$ Sefer ve ark.

Tabla II. Nonhemolitik vakalann cinsiyet, ya~. ag1rhk, hemoglobin (Hb), periferik yayma (PY), retikulosit (RT). coombs testi ve intrauterin infeksiyonlar (TORCH) yonunden degerleri.

S1ra No Cins Ya~ Ag1rhk Hb PY RT Coombs TORCH (K1z-Erkek) (gr) (gr/dl) (Hemoliz) (%) (lg M veya lg G)

1 E 6 gun 3200 19.1 1-2 2 E 12 gun 3650 15 2-3 3 K 3 gun 2750 16.8 3-4 4 E 4 gOn 2700 18.5 3-4 5 K 7 gun 2850 15.3 1-2 6 E 5 gOn 2950 16.5 1-2 7 E 5 gun 3400 15.9 2-3 8 E 3 gOn 3200 17.4 1-2 9 E 4 gun 3150 15 2-3

10 E 5 gun 2650 16.4 2-3 11 E 6 gun 2850 15.2 2-3 12 E 5 gun 2800 17.3 3-4 13 K 4 gun 3100 17.8 2-3 14 E 7 gun 2900 16 2-3

- Hemoliz yok + Hafif hemoliz ++ Orta hemoliz +++ $iddetli hemoliz

Tabla Ill. Kontrol grubu vakalann cinsiyet, ya~ . ag1rhk, hemoglobin (Hb), periferik yayma (PY), retikOiosit (RT), coombs testi ve intrauterin infeksiyonlar (TORCH) yonOnden

degerleri.

S1ra No Cins Ya~ A(j!rhk Hb PY RT Coombs TORCH (K1z-Erkek) (gr) (gr/dl) (Hernoliz) (%) (lg M veya lg G)

1 K 0 3050 21.4 1-2 2 K 0 3870 17 1-2 3 E 0 3200 18.2 1-2 4 E 0 3100 19.7 1-2 5 E 0 3740 18.9 2-3 6 E 0 3550 18.4 2-3 7 E 0 3150 17.7 1-2 8 K o. 3450 18.3 1-2 9 E 0 2800 17.7 2-3

10 E 0 3600 18.8 2-3 11 K 0 2800 18 1-2 12 K 0 2100 17 2-3 CMV lg G 13 K 0 2950 18.2 1-2

E- Erkek K-KIZ

Erciyes T1p Dergisi/ 1411992 34

Yenidogan D6nemi San!Jklannda Eritrosit Zan Na+ -K+ ATPaz, Mg2+ATPaz ve Magnezyum lli§-kileri: KUMANDA$ Sefer ve ark.

Eritrosit zan Na+-K+ATPaz ve Mg2+ATPaz aktiviteleri nonhemolitik grupta hemolitik gruba gore ve her iki grupta kontrol grubuna gore dO~Ok bulundu. Bu degerler S1ras1yla, hemolitik grupta 229.0±11.5 ve 235.8±12.0, nonhemolitik grupta 282.0±14.0 ve 31 0.4±18.7, kontrol grubunda 356.2±29.1 ve 387.0±25.2 nMPi/saat/mg protein olarak saptand1. Her iki grubun plazma magnezyum dOzeyleri kontrol grubunun plazma Magnez-yum dOzeylerinden daha dO~Ok bulundu. Gruplann ortalama bilirubin, eritrosit zan

Na+-K+ATPaz ve Mg2+ATPaz aktivite

degerleri, plazma Mg2+ dOzeyleri Tablo IV' de kar~lla~t1rmah olarak verilmi~tir.

devam1 i

Yenidogan Donemi San!Jklannda Eritrosit Zan Na+ -K+ A TPaz, Mg2+A TPaz ve Magnezyum 1/i§-kileri: KUMANDA$ Sefer ve ark.

Mg2+ATPaz aktivitelerinin yenidogan donemindeki normal degerlerine ait bir bulgu saptayamad rk.

Hiperbilirubinemili yenidoganlarda yaptrgrmrz

bu

Yenidogan Donemi SaniJklarmda Eritrosit Zan Na+ -J

Yenidogan D6nemi San!Jklannda Eritrosit Zan Na+-K+ATPaz, Mg2+ATPaz ve Magnezyum lli$-kileri: KUMANDA$ Sefer ve ark.

17. Kleigman MR, Behrman ER : The fetus and the neonata/1 mfants. In Behrman ER, Vaughan CV (eds): Nelson Textbook of Pe-diatrics. Thirteenth ed, WB Saunders Co, Philadelphia 1987, pp 362-435.

18. Levine LM, Seldin WD : The effects ot chronic hypokalaemia, hyponatraemia ana acid-base alterations on erythrocyte sodium. Transport Clln Sci 43:251-263, 1972.

19. Lowry OH, Rosebrough NJ, Farr AL, et a/: Protein measurement with the folin phenol reagent. J Bioi Chem 193:265-275, 1951.

20. Lux ES : Disorders of the red cell membrane. In Nathan DG, Oski F (eds): Hematology of Infancy and Childhood. Third ed, WB Saunders Co, Philadelphia 1987, pp 443-545.

21. Maisels JM: Neonatal jaundice. In Avery BG (ed): Neonatology Pathophysiology and Management of the Newborn. Third ed JB Lippincott Company, Philadelphia 1987, pp534-630.

22. Naylor JG: The relationship between age sodium metabolism in human erytrocytes. Gerontology 16:217-22, 1970.

23. Reading HW, lsbir T: The role of cation activated A TP'asis in transmitter release from the rat iris. Quart J Exp Physiol 65:105-115, 1980.

24.Sachs RJ: Interaction of magneswm w1th the sod1um pump of the human red cell. J Physlol400:577-591, 1988.

25. Stryer L: Membrane transport :.In Stryer L (eds) Biochemistry Third ed, WH Freedman and Company, New York 1988, pp 949-975.

Erciyes Tip Dergisi/1411992

26. Tezir; T, Saatr;i 0, Serpersu E, et a!: Reduced activity of erytrocyte Na+, K+ A TPase in hypothyroid children. Turk J Pediatr 28:231-236, 1986.

27. Torunoglu M: Kan Hastaiiklan Fizyopa-tolojisl. Ankara Oniversitesi T1p Fakultesi Yaym1, Ankara 1981, ss 225-325.

28. Tuncer M, Demirsoy S, 6zsoylu $. eta/: Yenidogan bebeklerin nedeni bilinmeyen hiperbilirubinemisinde anne ve kord kam serumunda r;inko, baklf ve magnezyum duzeyleri. Cocuk Sag ve Hast Derg 26:19-27,1983.

29. Wheeler PK, Walker AJ, Barker MD: Lipid requirement of the membrane sodium-plus-potassium ion-dependent adenosine triphosphatase system. Biochem J 146:713-722,1975.

30. Weissman N, Pileggi VJ: Inorganic ions. In: Henry RJ, Cannon C, Winkelman JW (eds): Clinical Chemistry Principles and Technics. Harper - Row Publishers, Hagerstown 1974, pp:677-699.

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